Nobody likes going to the doctor. Even doctors don't like going to the doctor! It doesn't matter whether it's the dentist for a cleaning, your MD for a yearly physical or your optometrist for an annual eye exam there's a huge list of things you'd rather do (like, anything else).
Enter the internet.
Health related issues are some of the most googled topics. Websites like WebMD have been around for ages and one of the first things people do when they get sick is google their symptoms. It would obviously be better for us to go and see a professional but it's easier to try and self diagnose. Of course, easier isn't necessarily better. I think we all know someone that's typed their symptoms into an online symptom check website and been told they have cancer, dengue fever or plague when really they have a cold. An online database simply isn't a replacement for the knowledge doctors possess and their ability to know what questions to ask, what problems to look for to understand, diagnose and then treat a problem.
So what about online eye exams? To be fair, we shouldn't call them that. They're really just online refractions (the part where your doctor of optometry asks you which looks clearer, one or two) perhaps better know as sight or vision tests. There's a lot of doubt about whether this is a good idea and the whole concept is illegal already in many US states. The question you might be asking as a consumer is, why?
There are a few reasons. It's important to know that your prescription comes from a lot more than just asking "Which is clearer, choice one or two". There's actually a fair amount of science, technique and skill that goes into that portion of the exam. If we were to take your responses at face value people would often end up with prescriptions that are too strong or otherwise not appropriate. Further to that, our offices are designed to make sure that the distances are accurate, the screens and fonts are high resolution, clear and colour true. By doing your refraction at home on your computer you might end up with inaccurate results because of how things were set up.
Optometrists also assess more than just vision. In fact, vision is only about one third of the eye exam. The other two major areas we look at are how your eye muscles work together (also known as binocularity) and your eye health. You might assume that if you had a problem with your eye muscles or health it would be obvious. Sometimes you're right. Most of the time though that's not the case. When there are symptoms they are often confusing.
Eye muscle problems can present as eyestrain, headaches, blurred vision, difficulty reading and more. It would be easy to assume that those problems were caused by poor vision or even something more serious like a stroke or tumour when often it's a misalignment of the eyes that can treated. An eye test online wouldn't be able to check for this.
Eye health is more concerning. There are many eye diseases that don't have symptoms in their earliest stages when damage is minimal and treatment is easier. Problems like glaucoma, retinal holes, macular degeneration or even eye cancer are all blinding disorders that won't affect your central vision right away and would be missed if someone is only getting a sight test. Further, optometrists are often the first doctors to diagnose problems such as high cholesterol, high blood pressure, MS, diabetes and certain brain cancers to name only a few whole body diseases that show up in the eye. Contact lenses pose a problem as well. There are many good reasons we insist on seeing our contact lens patients every year (check out the details here) but the take home message is that there are many contact lens related problems that can impact eye health and even cause vision loss that don't have severe symptoms. Your eyes are precious and irreplaceable. Risking your eye health simply isn't worth it.
Hopefully now you understand the massive difference between a sight test, especially one that's online, versus an actual eye exam from a doctor of optometry. Even if you still decide to use online sight tests I hope that this arms you with the full knowledge of what you are and are not receiving for your time and money.